Just Words

I sitting opposite my patient, the patient that the police have managed to stop from killing himself. This wasn't a cry for help, he had chosen three different suicide techniques, and then tried them all at once.

Blood drips from him onto the floor, he's crying as well so his tears mix in with the blood. Mucus is dribbling from his nose as he lets out huge heaving sobs. The police officer with him rubs his back with a gloved hand with her other hand she holds his arm, to stop him beating himself. The officer has formed a bond with my patient, one that I won't be able to replicate in the short time he is in my care. I leave the police officer to it as she's doing a fine job, one perhaps not in her normal job description.

We let him have a cigarette in the back of the ambulance with the doors open to let the smoke out, we are thankful that it's not a cold night. It's not 'allowed' but sometimes you have to break the rules for the patient. This is only the second time I've let someone light up in my ambulance. I'm away that the curtains are twitching in the tower blocks around us. A real life soap opera, entertainment illuminated by blue flashing lights.

He tells us the story of his life, one of pain and the worst forms of betrayal stretching from his childhood to the events that have brought him here tonight. Sometimes he has shown weakness, at other times a strength that I'm not sure I would have had. Often I wouldn't believe such stories, he won't meet my eyes as he talks but, instead of signifying deceit, it only makes his words truer. As his story comes to a conclusion I can see why he would want to kill himself. Everyone he has ever trusted has turned against him, not from simple neglect but from active abuse.

We leave him at the hospital, a side room with privacy. I thank the police officer for her help. I book him in, then head back to station to mop the floor of the ambulance – to remove the blood and the tears. It's my last job of the evening so I drive home. My car radio stays off, I drive in silence.

I have known him only for a moment, the police will know him for a little more, the nurses longer still.

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12 thoughts on “Just Words”

as a “mental health service user” i'm always torn by these stories. on the one hand i think 'well he got what he wanted – at least he's at peace now, why aren't people happy for him? it's all over”; then ten years later finding one small thing to keep going for – and it is worth it – and i would like to say thank you to whoever found me and saved my life – but you just don't know if you'll get that happy ending. ten years is a long time to go through absolute crap with no guarantees – i will always sympathyse with people who don't want to/cant wait that long.

It is tough to hear such things. I'm a volunteer counsellor with a well known national children's charity (among my many other day to day things) and have heard stories that just leave you thinking. Thankfully, I don't come face-to-face with those I speak to so it's not as tough, but it does leave you thinking and indeed that thinking lasts for days – sometimes longer.Your blogs tell the stories in few words, but in a way that has a massive impact.

Suicidal patients always pulled me in many directions. On the one hand, for far too many of them, I had little sympathy. I saw suicide as a cowardly act, the ultimate betrayal of one's self, and to the others the patient would leave behind. It also abhorred me from a more personal point of view: I lived with an autoimmune liver disease for 12 years, fought to stay alive long enough to get a liver transplant, and could not imagine giving up unless all hope was lost, and there was no chance of survival.On the other hand, I was not dealing with their own personal situations either, and had not dealt with any form of my own depression…..yet……..

It was not until some years after the transplant, when the whole of the experience, and all the years of working EMS came home to roost and crashed down on my head, (along with the death of one of my dearest friends) did I get some insight as to why people choose to depart this world by their own hand. It was still not something I considered during my own battle with depression, but it did allow me to have some more insights into why people would choose to do it.

Tom, Your blogs as so readable. No only recounting events that make us think, but showing them in such a way that makes us think for days.One thing that does come across, is that to be a Paramedic you need a lot more than just technical skills.

I know exactly what you've just been through. The one patient who sticks most clearly in my mind was a homeless gentleman we went to in London – the horrific stories he told of his life made it perfectly clear to me why he so desperately wanted to end it all. Eventually he walked off towards the railway – it was in the middle of a major event, so there was nothing we could do for him aside from a kind word and a cup of tea. I think that poor man's words will haunt me for ever.

Just Words……. by the sounds of your account, they are totally the opposite to that. I have only ever been to three “proper” suicide attempts. Two of which had been successful the other left me thinking, like I assume you are, for days as to why and how some people just seem to fall through the system (whether that be through their own choice or not) that is meant to be there to help them. We need to be able to do more for these people, but unfortunately some of them only ever appear on our radar when its either too late or just too far gone down the line. I have no suggestions as to how we can fix the problem, I just hope that somewhere someone who is contemplating taking their own life reads this and realises that sometimes it isn't the only option available. I also hope that those out there who use this option as a cry for help realise that we can be of assistance to them (and indeed the police) before it gets to the stage where they may cause unrepairable harm to themselves, and of course those people who do care for them (even if they are not showing it at the time)Or maybe I am just being naive.

In my experience in nursing, like you say some are cries for help, some are proper attempts to end a painful (in thier opinion) life.I've specialed many suicide watch patients when I was a nurse. I will add this, what they say can and does stay with you, but, I've seen the flip side, when a patient has recovered and thanks you for helping them. I know EMT's don't see this side as its the wards, but just imagine the person getting better and being grateful for the help they got at a dark time in thier lives

wow Tom u really do have a way with words. It just kind of puts your life into perspective really doesn't it. I mean i come home and feel really down some days and think that life couldn't get any worse but its stories like that that goes to prove that there is always someone worse off than you.

I found this heartbreaking but It also made me wonder.I have heard, I don't know if this is accurate, that the Chinese are less quick to prevent someone committing suicide because if they do this they are regarded as responsable for that person for the rest of their life.

I used to find that odd, but it makes a sort of sense, if someone seriously wants to kill themselves it is presumably because they find their current life unlivable for some reason. If they are “rescued” and then returned to that unliveable life have they been done a favour?

Is not the policewoman by making a connection with this man and then walking off and never seeing him again also betraying him in a human way (she is making a professional connection he is making a human one). All the people he deals with in hospital might be caring, but they have a whole infrastructure round them which he lacks.

I say this as somebody who has suffered severe depression and can certainly understand suicidal feelings, although I have not had the terrible experiences it appears your patient has had. I make have one suicide attempt when I was much younger, and was puzzeled and upset that I had been found (due to what can only be considered the clairvoyant feeling of a relative who was away and felt that they urgently needed to come and see me) and was fortunate to have been young enough to start over.

My question is really is there anything you think could actually help this man to live (as compared to returning to a sort of hell with a patched up body)?

I would also like to say that I really enjoy your blog, and appreciate your stoical humour.

HEYY !!I'VE NEARLY FINISHED READING OF BLOOD SWEAT AND TEA AS I STOLE IT FROM MY MOTHER WHO IS AN A&E NURSE.

MUST SAY . . SOME OF THE THINGS YOU PARAMEDICS HAVE TO DO IS JUST . . . UMM I DUNNO HOW TO PUT IT. HEARTBREAKING.

EVER SINCE I WAS ABOUT 6 (NOW 16) IV ALWAYS WANTED TO BE A PAEDS NURSE AS I HAVE SPENT SOME TIME IN HOSPITAL AND WANT TO RETURN THE FAVOUR, BUT NOW MY MIND HAS HONESTLY CHANGED AND IM THINKING OF GOING FOR A PARAMEDIC. ITS REALLY WEIRD !

NOW I KNOW IM MEANT TO WRITE ABOUT THIS PART OF THE BLOG BUT OH WELL ! IM NEW LET ME OFF !